The term “panic attack” is often used to describe any episode of anxiety or fear but there are specific symptoms that define a panic attack and distinguish it from a normal fear response.
What is a panic attack?
A panic attack is a short (less than 15 minutes) episode of intense fear that often is accompanied by a feeling that something terrible is happening or is about to happen. During a panic attack, someone may feel that they are going to die, lose control of themselves, or go crazy. Other symptoms that may occur during a panic attack include increased heart rate, sweating, shaking, shortness of breath, chest pain, nausea, dizziness, chills, and numbness or tingling sensations particularly in the hands and feet.
Panic attacks are not dangerous
The important thing to mention about panic attacks is that while the person having one may feel like they are about to die, lose control, or go crazy none of those things are going to happen. Because panic attacks can feel so overwhelming and involve real physical symptoms, it is understandable why someone having one might believe that something physically dangerous was happening to them. In fact, the worry that something physically dangerous is happening during a panic attack often causes more anxiety which in turn causes more physical symptoms and leads to a vicious cycle that fuels the attack. While heart rate does often increase during a panic episode, this is no more dangerous than engaging in moderate exercise.
Panic Disorder occurs when someone has panic attacks so often that they begin to spend a significant amount of their time worrying about having another attack, worrying that they are losing their mind, or changing their daily routine because of the panic attacks. If this lasts for a month or more, Panic Disorder is diagnosed.
Panic Attacks and Panic Disorder Treatment
While panic attacks may be one of the most terrifying and unpleasant experiences a person can endure, the good news is that they respond exceptionally well to treatment. Like most anxiety disorders, both medications and psychotherapy are effective for panic disorder. Many people fully recover from panic disorder without the use of medications, but anti-anxiety medications are sometimes used depending upon the frequency and severity of attacks. The psychotherapy that has the most evidence supporting its effectiveness for panic disorder is Cognitive Behavioral Therapy.
- Cognitive Behavioral Therapy for Panic Disorder
Cognitive Behavioral Therapy (CBT) involves learning the way thoughts, feelings, and behaviors are connected and using that knowledge to make changes to the patterns that underlie excessive anxiety. This approach works exceptionally well for panic disorder and it is the basis of the ABCtracker™ self-help program that can be used on this website for free. The ABCtracker™ was developed by medical doctors and psychologists at UCLA based on techniques from a large, government-funded study of anxiety. If you are struggling with panic attacks, try the ABCtracker™ and start feeling better now.
- Medications for Panic Disorder
There are several different classes of medications that are used to treat panic disorder. All of these types of medications reduce anxiety but do so in different ways and with different side effects and risks.
- Selective Serotonin Reuptake Inhibitors (SSRIs)
This class of medication works by increasing the signaling between neurons that use a chemical called serotonin to communicate with each other. For reasons that are not well understood, this increase in serotonin-mediated signaling decreases anxiety. SSRIs are taken every day regardless of anxiety level and usually take 6-8 weeks to reach full effect. The following drugs are classified as SSRIs: fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), and fluvoxamine (Luvox).
Other medications that are not SSRIs but increase serotonin-based signaling and are sometimes used to treat anxiety are serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor), tricyclic antidepressants such as clomipramine (Anafranil), monoamine oxidase inhibitors such as tranylcypromine (Parnate), and the serotonin partial agonist buspirone (Buspar).
Unlike SSRIs, benzodiazepines usually begin to reduce anxiety within an hour of taking them. This rapid efficacy is an appealing aspect of this drug class but also carries a risk for development of abuse or addiction to the drug. Most people who are prescribed benzodiazepines by their doctor for anxiety do not develop an addiction to them. However, when benzodiazepines are taken frequently for a prolonged period of time, stopping them suddenly can result in an unpleasant and potentially dangerous withdrawal syndrome. The following are examples of some commonly prescribed benzodiazepines: diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax).
There are several other medications that are sometimes prescribed for anxiety and are not SSRIs or benzodiazepines. These include gabapentin (Neurontin), quetiapine (Seroquel), and hydroxyzine (Atarax).
- Selective Serotonin Reuptake Inhibitors (SSRIs)